title: [A case report of ultrasound guided peripheral nerve block for lower extremity amputation of a patient with anti-phospholipid syndrome].
abstract: A 60-year-old female with anti-phospholipid syndrome underwent amputation of her left lower limb. She had had a history of cerebral infarction, cerebral hemorrhage, coagulation abnormalities, thrombocytopenia, and pneumothorax, and just recovered from disseminated intravascular coagulation. After intravenous fentanyl 25 microg, ultrasound-guided sciatic, femoral and lateral femoral cutaneous nerve blocks were performed. We used 0.75% ropivacaine 15 ml and 1% lidocaine 15 ml for sciatic nerve block, 0.75% ropivacaine 5 ml and 1% lidocaine 5 ml for femoral nerve block and 0.75% ropivacaine 5 ml for femoral cutaneous nerve block. For femoral nerve block, a catheter was inserted and ropivacaine was infused at 4 ml x hr(-1) after surgery. Amputation at the left thigh was successfully performed and postoperative course was uneventful. The sciatic, femoral and lateral femoral cutaneous nerve blocks were useful for amputation of a patient with severe coagulopathy by anti-phospholipid syndrome.
authors.affiliation: Department of Anesthesiology and Critical Care, Higashi Omiya General Hospital, Saitama 337-0051.
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Kohno
authors.forename: Keiko
authors.initials: K
authors.lastname: Koishi
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Fujii
authors.forename: Tomoki
authors.initials: T
authors.lastname: Nishiyama
mesh_terms: D000577:Amides / Q000008:administration & dosage; D000671:Amputation, Surgical; D016736:Antiphospholipid Syndrome / Q000150:complications*; D005260:Female; D006801:Humans; D007866:Leg / Q000294:innervation / Q000601:surgery*; D008012:Lidocaine / Q000008:administration & dosage; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010525:Peripheral Nerves / Q000000981:diagnostic imaging; D000077212:Ropivacaine; D014463:Ultrasonography
chemical_list: D000577:Amides; D000077212:Ropivacaine; D008012:Lidocaine